Pathophysiology of a Subdural Hematoma, Research Paper Example

A subdural hematoma is defined as “a collection of blood on the surface of the brain,” and are typically “the result of a serious head injury” (PubMed Health, 2011). This condition is very serious in nature, and requires immediate medical attention, due to the many complications that may result in a rapid manner (PubMed Health, 2011).However, in some cases where patients are more fragile, a smaller and less disruptive head injury may lead to a subdural hematoma, which may or may not be diagnosed over a longer period of time, and which may also lead to death if not treated properly (PubMed Health, 2011). It is believed that there are a number of different risk factors that may lead to subdural hematomas in patients of all ages, including but not limited to anticoagulant therapies, ongoing falls, and prior head injuries (PubMed Health, 2011). The primary noticeable symptoms of a subdural hematoma include speech problems, headaches, confusion, and seizures, amongst others (PubMed Health, 2011). However, a definitive diagnosis must be determined prior to making any decisions regarding treatment (PubMed Health, 2011). In a clinical context, “low-pressure venous bleeding of bridging veins (between the cortex and venous sinuses) dissects the arachnoid away from the dura and layers out along the cerebral convexity. Cerebral injury results from direct pressure, increased intracranial pressure (ICP), or associated intraparenchymal insults” (Medscape, 2011). Therefore, subdural hematomas require ongoing consideration and evaluation to determine their cause and how to treat the condition, given the state of the hematoma at the time of diagnosis (Medscape, 2011).

Diagnostic Tests

In diagnosing a subdural hematoma, it is important to perform the appropriate diagnostic tests to ensure that the patient is protected from further risk or harm. Upon admission to a healthcare facility, “The diagnosis of a head injury is made with a physical examination and diagnostic tests. During the examination, the physician obtains a complete medical history of the patient and family and asks how the injury occurred. Trauma to the head can cause neurological problems and may require further medical follow up” (New York-Presbyterian, 2011). Furthermore, “Any abnormality of mental status that cannot be explained completely by alcohol intoxication or the presence of another mind-altering substance should increase suspicion of SDH in the patient with blunt head trauma. Obtain an urgent CT scan” (Medscape, 2011).The basic diagnostic tests include blood tests, X-Rays, and CAT Scans, in addition to EEGs and MRIs (New York-Presbyterian, 2011).These tests, used individually or in combination, are likely to determine a diagnosis, and if a subdural hematoma can be identified. It is expected that once a diagnosis is definitive, treatment options will be explored immediately, and will begin accordingly.

Evaluation, Education, and Health Promotion for Patients

For patients that have experienced a subdural hematoma, obtaining medical attention in a timely manner is essential to ensure that patients secure proper treatment as quickly as possible. Therefore, it is important for patients that might exhibit any symptoms of a subdural hematoma to be seen by an emergency medical team as soon as possible to prevent permanent damage and even death. These efforts require patients that have experienced any type of head injury to be evaluated almost immediately by a medical professional to determine a diagnosis, and to also address the condition and its potential outcomes as best as possible. With a neurological examination and evaluation, there is sufficient means to determine whether or not a patient is suffering from this condition. To be specific, “Management of the patient with subdural hematoma begins with careful neurologic evaluation and study of the CT scan. The scan will demonstrate the size of the clot and its age. More acute blood is hyperdense on CT scan and as clots liquefy over time they become isodense to brain and subsequently hypodense to eventually assume the same CT characteristics as the cerebro spinal fluid. The degree of cerebral compression and the shift of the midline, taken in conjunction with the patients neurologic evaluation determines the acuity of surgery” (Saint Barnabas, 2011). Therefore, it is expected that a patient suffering from a subdural hematoma will obtain expert medical advice and diagnostic testing to determine the extent of the injury, as well as the opportunities that are available to support the patient’s treatment strategy and recovery (Saint Barnabas, 2011). It is expected that for patients suffering from a subdural hematoma, there must be some degree of stability, which requires the patient to refrain from excessive movement for a period of time, particularly when surgery is warranted, because this will provide the brain some time to heal, and for the clot to subside (Saint Barnabas, 2011).

Conducting educational and outreach efforts for patients at risk for or who have suffered from a subdural hematoma require further education regarding the condition, its severity, and patient prognoses (Harvard Medical School, 2011). Therefore, patients must be provided with educational opportunities to learn about the condition more fully, and what could happen if a patient experiences this condition. The basic premise of the condition requires immediate medical attention, noted as follows: “An acute subdural hemorrhage develops over minutes to hours. If not diagnosed and treated promptly, it can cause severe brain injury and death. A chronic subdural hemorrhage develops over weeks to months. Symptoms may develop slowly and may be subtle.  As is the case with any brain injury, symptoms can be slow to go away after a subdural hematoma is treated, and some symptoms may be permanent” (Harvard Medical School, 2011). Therefore, it is expected that patients who are provided with information regarding this condition will possess the knowledge that is necessary to ensure that medical directives are sought in the event that a subdural hematoma is suspected, either with or without an acute head injury (Harvard Medical School, 2011). Therefore, it is important for all persons to take any and all precautions and measures that are necessary to ensure that they are protected from subdural hematomas as best as possible. However, when this risk is unavoidable, it is important to consider how to best approach this condition with the knowledge and medical expertise that is necessary to make an appropriate and definitive diagnosis. As a result, it is important to determine how to best approach this situation to ensure that all necessary diagnostic testing and other required procedures and examinations take place as quickly and as efficiently as possible. These efforts will demonstrate the importance of the condition and the immediate attention that it requires.

References

Harvard Medical School (2011). Subdural hematoma. Retrieved from http://www.patientedu.org/aspx/HealthELibrary/HealthETopic.aspx?cid=210407

Medscape (2011). Subdural hematoma in emergency medicine. Retrieved from http://emedicine.medscape.com/article/828005-overview

New York-Presbyterian (2011). Subdural hematoma. Retrieved from http://nyp.org/health/subdural-hematoma.html

PubMed Health (2011). Subdural hematoma. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001732/

Saint Barnabas (2011). Chronic and acute subdural hematoma. Retrieved from http://www.saintbarnabas.com/services/neuro/neurosurgery/surgery/brain/hematoma.html